WO2010076818A1 - Dispositif de retrait de caillot sanguin - Google Patents

Dispositif de retrait de caillot sanguin Download PDF

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Publication number
WO2010076818A1
WO2010076818A1 PCT/IT2008/000806 IT2008000806W WO2010076818A1 WO 2010076818 A1 WO2010076818 A1 WO 2010076818A1 IT 2008000806 W IT2008000806 W IT 2008000806W WO 2010076818 A1 WO2010076818 A1 WO 2010076818A1
Authority
WO
WIPO (PCT)
Prior art keywords
tubular body
length
inner cable
capture member
helical
Prior art date
Application number
PCT/IT2008/000806
Other languages
English (en)
Inventor
Massimo Morero
Original Assignee
Invatec S.P.A.
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Invatec S.P.A. filed Critical Invatec S.P.A.
Priority to PCT/IT2008/000806 priority Critical patent/WO2010076818A1/fr
Priority to US13/140,403 priority patent/US8998946B2/en
Priority to EP08876156.4A priority patent/EP2384151B1/fr
Publication of WO2010076818A1 publication Critical patent/WO2010076818A1/fr

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
    • A61B17/221—Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00831—Material properties
    • A61B2017/00867—Material properties shape memory effect
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
    • A61B17/22031—Gripping instruments, e.g. forceps, for removing or smashing calculi
    • A61B2017/22034—Gripping instruments, e.g. forceps, for removing or smashing calculi for gripping the obstruction or the tissue part from inside
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
    • A61B17/221—Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions
    • A61B2017/2217—Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions single wire changing shape to a gripping configuration

Definitions

  • the present invention relates to a blood clot removal device .
  • Blood clot removal devices are known, which allow removing organic material from within anatomical lumens.
  • the wire is completely withdrawn from the catheter to bring the section thereof back to the helical position, then inserting into the catheter lumen, which otherwise would result to be too much deformable, a pressurized fluid which stiffens the body thereof during the blood clot gripping manoeuvres .
  • a second wire is present, which is connected to the tip thereof, and able to strain the helical section thereof.
  • the problem underlying the present invention is to overcome the drawbacks of the art hereto known by providing a blood clot removal device and a method for implementing such device, capable of an efficient removal of the blood clots also from vessels of reduced transversal dimensions .
  • Said longitudinal lumen of said tubular body receives an inner cable so that it remains within said helical length.
  • Said inner cable comprises a proximal length having a proximal manoeuvring end, and a distal length provided with a tip.
  • the device comprises a micro- catheter in which the capture member of the blood clot is slidably introduced.
  • This capture member has an inner lumen, an essentially straight proximal portion, and a helical flexible distal portion.
  • a metal cable is provided, which is received in the capture member lumen and anchored to the distal end thereof .
  • the physician deploys the capture member, releasing it from the micro-catheter inner lumen.
  • the flexible distal portion of the capture member protruding from the micro-catheter locates itself according to the helical configuration thereof, and entraps the blood clot.
  • the device in order to be introduced in the branch where the blood clot is present, in accordance with an embodiment, does not require to be stiffened in a stretched position or with the coils strained or extended to bring the distal portion in an essentially rectilinear configuration, in other words, it does not need a wire which, once internally pushed in the distal direction, extends the distal portion in the rectilinear position, thus stiffening the device, it is possible to keep an optimal manoeuvrability which ensures a higher progression easiness along the optional tortuous paths of the vessels to reach the vessel length to be treated. Therefore, the proposed solution has a capture member which is particularly flexible and with optimal traceability performance.
  • FIG. 9 shows, according to a still further embodiment, a sectional view of a micro-catheter distal end from which a capture member distally protrudes in a deployed and relaxed position, in which an inner cable is received;
  • Fig. 10 shows the section according to the line X-X of the capture member with cable of Fig. 9;
  • FIG. 12 illustrates an withdrawal step of a blood clot from a vessel with a device according to a further embodiment
  • Fig. 17 shows a side view of the distal part of a capture member
  • Fig. 18 shows a side view of the distal part of a micro-catheter
  • Fig. 19 illustrates a partially sectional side view of the distal part of a capture member in which an inner cable is received
  • FIG. 21 shows a partially sectional side view of a micro-catheter distal part from which the helical length of a capture member with inner cable according to a further embodiment completely protrudes, in which the capture member proximal part is asymmetrically arranged relative to the longitudinal axis around which helical length deploys;
  • Fig. 35 shows a partially sectional side view of the proximal part of the device according to the Fig. 34;
  • Fig. 36 illustrates, according to a still further embodiment, a sectional view of a micro-catheter distal end from which a capture member distally protrudes in a deployed and relaxed position, in which an inner cable is received;
  • FIG. 37 illustrates, according to a still further embodiment, in a sectional side view, a capture member distal end with inner cable according to a different embodiment .
  • a blood clot removal device 1 comprises a capture member 2 having tubular body 3 with prevailing longitudinal extension.
  • Said tubular body 3 comprises a lumen 10 longitudinally extending in said body 3 from a proximal end thereof to a distal end thereof.
  • Said tubular body 3 comprises at least one proximal portion 4, at least one distal portion 5, an apical end 6 of said distal portion 5, and a tip 7 ( Figures 1, 5, 7, 9, 21, 34, and 36) .
  • said at least one distal portion 5 of said capture member comprises at least one helical length 8 provided with coils 16. These coils 16 are wrapped in a helical manner and form one to the other a pitch w p" in the longitudinal direction which, in accordance with an embodiment, is constant when the helical length 8 is relaxed or in non-stressed conditions.
  • Said coils 16 of said helical length 8 are suitably arranged, when deployed in non-stressed conditions, to the capture of blood clots 9 present in a vessel having transversal dimensions, for example, essentially slightly above the helical length maximum transversal dimension.
  • an inner cable 11 is received in said longitudinal lumen 10 of said tubular body 3.
  • said inner cable 11 remains inside the tubular body 3 also along said helical length 8.
  • said inner cable 11 comprises a proximal length 12, comprising a proximal manoeuvring end 13 , and a distal length 14 , provided with a tip 15.
  • said proximal manoeuvring end 13 is adapted to proximally protrude from said capture member 2.
  • At least one securing portion 30 of said distal length 14 of said inner cable 11 is secured to said apical end 6 of said tubular body 3 of the capture member 2.
  • said securing portion 30 is firmly secured to said apical end 6 so that, when said inner cable 11 is subjected to a relative movement relative to the capture member 2 in the proximal direction, said inner cable 11 brings the apical end 6 of the tubular body 3 closer to the proximal portion thereof 4, shortening the pitch "p" of said coils 16 of the capture member 2 helical length 8.
  • said capture member 2 at least in the helical length 8, is in a shape memory elastic material, for example, superelastic, preferably in NitinolTM, for example, adapted to remain elastic also when stressed in an essentially rectilinear deployed configuration.
  • a shape memory elastic material for example, superelastic, preferably in NitinolTM, for example, adapted to remain elastic also when stressed in an essentially rectilinear deployed configuration.
  • At least one proximal length 4 of the capture member 2 is in a first material adapted to support at least the stresses adapted to retract said capture member 2 to remove a blood clot, and at least one helical length 8 of the capture member 2 in a shape memory elastic material, for example, adapted to remain elastic also when stressed in an essentially- rectilinear deployed configuration.
  • said helical length 8 extends along a longitudinal axis Y-Y from a proximal end 20 to a distal end 21, and comprises a plurality of coils 16 which little by little approach said longitudinal axis Y-Y passing from said proximal end 20 to said distal end 21, so as to constitute a receptacle or pocket arranged transversally to a vessel and to form a seat able to capture, at least partially contain, and retain, a blood clot to be removed.
  • said coils 16 of said helical length 8 essentially have a helical shape, for example, but not necessarily, cylindrical, and advantageously, in accordance with a further embodiment, with a diameter decreasing from 5mm at the proximal end 20 of the helical length 8 to a diameter of lmm at the distal end 21 of the helical length 8.
  • said helical length 8 has from 3 (three) to 9 (nine) coils, preferably it has 6 (six) coils.
  • said further distal length 22 comprises a folded portion 23 towards the tubular body 3 proximal portion 4, starting from the apical end 6, preferably entering with a length 24 of said folded portion 23 between said helical coils 16 of the helical length 8 where the blood clot 9 is received, so as, for example, to at least partially insert said length 24 • of said folded portion 23 in the blood clot 9 and to secure it to the device 1 ( Figures 7, 9, 36) .
  • a further preferably rectilinear first distal length 22 is provided distally to said helical length 8, ending in said tip 7, and at the same time a further folded portion 23 is provided towards the proximal portion 4 of the tubular body 3, preferably entering with a length 24 of said folded portion 23 between said helical coils 16 of the helical v length 8 where the blood clot 9 is received (Fig. 36) .
  • indicating members 26 of the cable 11 position relative to the tubular body 3 are associated, directly or by means of manoeuvring members 25, for example, chromatic indicating members or graduated indicating members capable of indicating the inner cable 11 relative position relative to the tubular body 3 (Fig. 34) .
  • the proximal end tubular body 3 has a manoeuvring portion 31 comprising an adjustable coupling with manoeuvring members 25 of the inner cable 11, so as to adjust the relative position of the inner cable 11 and the tubular body 3 proximal portions .
  • the capture member 2 tubular body 3 comprises a preferably externally threaded handle 34 at the proximal end 4, on which a closure member 35 is screwed, to which the inner cable 11 proximal end 12 is connected, for example, in accordance with an embodiment, received in a seat provided in the closure member 35 which allows an axial traction from the inner cable 11, thus avoiding a rotation or torsion thereof during the adjustment .
  • this embodiment which results to be less flexible than those previously described, can be used where the path to be travelled by the device is less tortuous, but with very reduced dimensions, for example, with vessels having very small cross-sections, allowing reaching the blood clot and passing beyond it without using further containment members as a micro-catheter.
  • the inner cable 11 is released by bringing the coils 16 back to a helical position, and the inner cable 11 is used during the capture and traction of the blood clot to adjust the strain of the helical length 8 and, particularly, the pitch w p" between the coils 16.
  • Said catheter 27 is, for example, useful also to remove from the treated vessel optional small portions 36 of blood clot 36 which were to be split from the blood clot 9 main mass during the capture and removal manoeuvres, for example, by returning or sucking into the catheter lumen 29 a part of the fluid present in the vessel within the catheter after that the capture member 2 with the blood clot 9 have been completely retracted in the catheter lumen 29 (Figs. 30 to 33) .
  • An assembling method of a blood clot removal device comprising the steps of:
  • the further step of making a portion of the inner cable 11 proximal length 12 to protrude from the tubular body 3 proximal end is provided.

Landscapes

  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Vascular Medicine (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)

Abstract

L'invention porte sur un dispositif de retrait de caillot sanguin (1), comprenant un élément de capture (2) comportant un corps tubulaire (3) à extension principalement longitudinale et comportant une lumière (10) s'étendant longitudinalement dans ledit corps tubulaire (3), au moins une partie proximale (4), au moins une partie distale (5), une extrémité apicale (6) de ladite partie distale (5), et un embout (7); ladite ou lesdites parties distales (5) dudit élément de capture (2) comprenant au moins une longueur hélicoïdale (8), comportant des spires (16) enroulées en hélice et constituant un pas (p) entre elles dans la direction longitudinale et servant à capturer les caillots sanguins (9); un câble intérieur (11) reçu dans ladite lumière longitudinale (10) dudit corps tubulaire (3) de façon à rester dans ladite longueur hélicoïdale (8) du corps tubulaire (3), ledit câble intérieur (11) présentant une longueur proximale (12) ayant une extrémité proximale de manœuvre (13) et une longueur distale (14) comportant un embout (15); ledit embout (15) dudit câble intérieur (11) étant fixé à ladite extrémité apicale (6) dudit corps tubulaire (3) de l'élément de capture (2), ledit embout (15) étant solidement fixé à ladite extrémité apicale (6) de telle sorte que, lorsque ledit câble intérieur (11) est soumis à un mouvement relatif par rapport à l'élément de capture (2) dans la direction proximale, ledit câble intérieur (11) amène l'extrémité apicale (6) du corps tubulaire (3) à se rapprocher de la partie proximale de celui-ci, raccourcissant ainsi le pas (p) desdites spires (16) de la longueur hélicoïdale (8) de l'élément de capture (2) du caillot sanguin (9).
PCT/IT2008/000806 2008-12-30 2008-12-30 Dispositif de retrait de caillot sanguin WO2010076818A1 (fr)

Priority Applications (3)

Application Number Priority Date Filing Date Title
PCT/IT2008/000806 WO2010076818A1 (fr) 2008-12-30 2008-12-30 Dispositif de retrait de caillot sanguin
US13/140,403 US8998946B2 (en) 2008-12-30 2008-12-30 Blood clot removal device
EP08876156.4A EP2384151B1 (fr) 2008-12-30 2008-12-30 Dispositif de retrait de caillot sanguin

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
PCT/IT2008/000806 WO2010076818A1 (fr) 2008-12-30 2008-12-30 Dispositif de retrait de caillot sanguin

Publications (1)

Publication Number Publication Date
WO2010076818A1 true WO2010076818A1 (fr) 2010-07-08

Family

ID=41010298

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/IT2008/000806 WO2010076818A1 (fr) 2008-12-30 2008-12-30 Dispositif de retrait de caillot sanguin

Country Status (3)

Country Link
US (1) US8998946B2 (fr)
EP (1) EP2384151B1 (fr)
WO (1) WO2010076818A1 (fr)

Cited By (1)

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CN105147360A (zh) * 2015-10-10 2015-12-16 江苏耀华医疗器械科技有限公司 一种取石网篮

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USD762852S1 (en) * 2014-02-19 2016-08-02 Karl Storz Gmbh & Co. Kg Medical instrument with spiral tip
US9655634B2 (en) 2014-06-12 2017-05-23 Innon Holdings, Llc Endoscopic stone-extraction device
US10448962B2 (en) 2014-06-12 2019-10-22 Innon Holdings, Llc Endoscopic stone-extraction device
JP6423216B2 (ja) * 2014-09-19 2018-11-14 テルモ株式会社 結石除去装置
EP4252992A3 (fr) 2016-02-24 2024-01-10 Incept, LLC Cathéter neurovasculaire à flexibilité améliorée
US10610669B2 (en) 2016-03-16 2020-04-07 Krishna Rocha-Singh, M.D. Apparatus and method for promoting angiogenesis in ischemic tissue
US10065018B2 (en) 2016-03-16 2018-09-04 Krishna Rocha-Singh Apparatus and method for promoting angiogenesis in ischemic tissue
US10543006B2 (en) 2016-06-09 2020-01-28 Boston Scientific Scimed, Inc. Infusion catheter
JP7264581B2 (ja) 2017-01-06 2023-04-25 インセプト、リミテッド、ライアビリティ、カンパニー 動脈瘤治療装置向けの抗血栓性コーティング
EP3787523A4 (fr) 2018-05-01 2022-02-23 Incept, LLC Dispositifs et procédés de retrait de matériau obstructif d'un site intravasculaire
US11395665B2 (en) 2018-05-01 2022-07-26 Incept, Llc Devices and methods for removing obstructive material, from an intravascular site
US11471582B2 (en) 2018-07-06 2022-10-18 Incept, Llc Vacuum transfer tool for extendable catheter
US11517335B2 (en) 2018-07-06 2022-12-06 Incept, Llc Sealed neurovascular extendable catheter
US11766539B2 (en) 2019-03-29 2023-09-26 Incept, Llc Enhanced flexibility neurovascular catheter
CN113347916A (zh) 2019-10-15 2021-09-03 因普瑞缇夫护理公司 用于多变量卒中检测的系统和方法
US11638637B2 (en) 2019-12-18 2023-05-02 Imperative Care, Inc. Method of removing embolic material with thrombus engagement tool
US20210315598A1 (en) 2019-12-18 2021-10-14 Imperative Care, Inc. Methods of placing large bore aspiration catheters
CN113365687A (zh) 2019-12-18 2021-09-07 因普瑞缇夫护理公司 治疗静脉血栓栓塞疾病的方法和系统
US20230248503A1 (en) * 2019-12-18 2023-08-10 Imperative Care, Inc. Sterile field clot capture module for use in thrombectomy system
WO2021183444A1 (fr) 2020-03-10 2021-09-16 Imperative Care, Inc. Cathéter neurovasculaire à flexibilité améliorée
USD943708S1 (en) * 2020-06-09 2022-02-15 Water Evaporation Systems, Llc Wastewater atomization nozzle
US11207497B1 (en) 2020-08-11 2021-12-28 Imperative Care, Inc. Catheter with enhanced tensile strength
CN117122377B (zh) * 2023-04-04 2024-04-23 上海中医药大学附属曙光医院 一种取石导丝及输尿管镜
CN116942255B (zh) * 2023-09-18 2023-12-12 北京华脉泰科医疗器械股份有限公司 血栓去除装置

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US4706671A (en) * 1985-05-02 1987-11-17 Weinrib Harry P Catheter with coiled tip
EP0330843A1 (fr) * 1988-03-04 1989-09-06 ANGIOMED Aktiengesellschaft Procédé et dispositif pour enlever des dépôts dans les vaisseuax sanguins et les organes d'êtres vivants
US20030040762A1 (en) * 2001-08-22 2003-02-27 Gerald Dorros Apparatus and methods for treating stroke and controlling cerebral flow characteristics
US20060009784A1 (en) * 2004-07-07 2006-01-12 Percutaneous Systems, Inc. Methods and apparatus for deploying conformed structures in body lumens
WO2006084019A2 (fr) * 2005-02-01 2006-08-10 Primus Medical Group, Llc. Anse dotee d'un dispositif d'augmentation de la zone de capture

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Publication number Priority date Publication date Assignee Title
CN105147360A (zh) * 2015-10-10 2015-12-16 江苏耀华医疗器械科技有限公司 一种取石网篮

Also Published As

Publication number Publication date
US20110295305A1 (en) 2011-12-01
EP2384151B1 (fr) 2021-04-21
US8998946B2 (en) 2015-04-07
EP2384151A1 (fr) 2011-11-09

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